Subcutaneous Panniculitis-like T-cell Lymphoma: A Case Report
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Abstract
Background: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is rare. The diagnosis of the SPTCL is difficult and challenge due to its mimics other disease or conditions. Furthermore, the pathological diagnosis from skin and subcutaneous tissue biopsy may require multiple times due to high number of false negatives. A case report aims to present the full course of clinical manifestations, imaging features and diagnosis of SPTCL for further benefit of providing care the other patients.
Methods: Case study design was conducted. The medical record was reviewed for the clinical information, laboratory findings, radiological investigations and pathological results.
Results: A 45-year-old male presented with prolonged fever, legs pain, weight loss, enlarged lymph nodes and subcutaneous nodules at the abdominal wall. The ultrasound finding was focal hyperechoic subcutaneous lesions. The findings of chest and abdominal computed tomography (CT) were multiple ill-defined enhancing nodules and infiltrative lesions in the subcutaneous layer, without lymphadenopathy detected on imaging. After multiple visits of follow up and several tissue biopsy, the patient was definitely diagnosed SPTCL from tissue biopsy and received the successful treatment.
Conclusion: The patient with multiple subcutaneous nodules by clinical manifestations and radiological results should include the subcutaneous panniculitis-like T-cell lymphoma in the differential diagnosis.
Keywords: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL), subcutaneous nodules
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References
Freedman AS, Aster JC. Clinical manifestations, pathologic features, and diagnosis of subcutaneous panniculitis-like T cell lymphoma, [internet]. Uptodate 2018. [Cited 2020 June 15]. Aviable from:URL: https://www.uptodate.com/contents/ clinical-manifestations-pathologic-fea tures-and-diagnosis-of-subcutaneous-pan niculitis-like-t-cell-lymphoma.
Damasco F, Akilov OE. Rare Cutaneous T-Cell Lymphomas. Hematol Oncol Clin North Am 2019;33(1):135-48.
Willemze R, Jansen PM, Cerroni L, Berti E, Santucci M, Assaf C, et al. Subcutaneous panniculitis-like T-cell lymphoma: definition, classification, and prognostic factors: an EORTC Cutaneous Lymphoma Group study of 83 cases. Blood 2008;111(2):838-45.
Paulli M, Berti E. Cutaneous T-cell lymphomas (including rare subtypes). Current concepts. II. Haematologica 2004;89(11):1372-88.
Bagheri F, Cervellione KL, Delgado B, Abrante L, Cervantes J, Patel J, et al. An illustrative case of subcutaneous panniculitis-like T-cell lymphoma. J Skin Cancer 2011;2011:824528
Gonzalez CL, Medeiros LJ, Braziel RM, Jaffe ES. T-cell lymphoma involving subcutaneous tissue. A clinicopathologic entity commonly associated with hemo phagocytic syndrome. Am J Surg Pathol 1991;15(1):17-27.
Salhany KE, Macon WR, Choi JK, Elenitsas R, Lessin SR, Felgar RE, et al. Subcutaneous panniculitis-like T-cell lymphoma: clinico pathologic, immunophenotypic, and genotypic analysis of alpha/beta and gamma/delta subtypes. Am J Surg Pathol 1998;22(7):881-93
.
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127(20):2375-90.
Lopez-Lerma I, Penate Y, Gallardo F, Marti RM, Mitxelena J, Bielsa I, et al. Subcutaneous panniculitis-like T-cell lymphoma : Clinical features, therapeutic approach, and outcome in a case series of 16 patients. J Am Acad Dermatol 2018;79(5):892-8.
Kong YY, Dai B, Kong JC, Zhou XY, Lu HF, Shen L, et al. Subcutaneous panniculitislike T-cell lymphoma: a clinicopathologic, immunophenotypic, and molecular study of 22 Asian cases according to WFIO-EORTC classification. Am J Surg Pathol 2008;32(10):1495-502.
Rutnin S, Porntharukcharoen S, Boonsakan P. Clinicopathologic, immunophenotypic, and molecular analysis of subcutaneous panniculitis-like T-cell lymphoma : A retrospective study in a tertiary care center. J Cutan Pathol 2019;46(1):44-51.
Wang BH, Xu XL, Sun JF. Subcutaneous panniculitis-like T-cell lymphoma: A case report. Int J Dermatol Venereol 2019;2(2):109-11.
Flashimoto R, Uchiyama M, Maeno T. Case report of subcutaneous panniculitis-like T-cell lymphoma complicated by eyelid swelling. BMC Ophthalmol 2016;16:117.
Kim JW, Chae EJ, Park YS, Lee HJ, Hwang HJ, Lim C, et.al. Radiological and Clinical Features of Subcutaneous Panniculitis-Like T-Cell Lymphoma. J Comput Assist Tomogr 2011;35(3):394-401.
Xu L, Che Y, Ding X, Song J, Zhang X, Sun X. Successful treatment of a rare subcutaneous panniculitis-like T-cell lymphoma: An unusual case report and literature review. Dermatol Ther 2019;32(3):e12878.
Ohtsuka M, Miura T, Yamamoto T. Clinical characteristics, differential diagnosis, and treatment outcome of subcutaneous panniculitis-like T-cell lymphoma: a literature review of published Japanese cases Eur J Dermatol 2017;27(1):34-41.
LeBlanc RE, Tavallaee M, Kim YH, Kim J. Useful Parameters for Distinguishing Subcutaneous Panniculitis-like T-Cell Lymphoma From Lupus Erythematosus Panniculitis. Am J Surg Pathol 2016;40(6):745-54.
Chiou HJ, Chou YH, Chiou SY, Chen WM, Chen W, Wang HK, et al. High-resolution ultrasonography of primary peripheral soft tissue lymphoma. J Ultrasound Med 2005; 24(1):77-86.
Nessi R, Betti R, Bencini PL, Crosti C, Blan M, Uslenghi C. Ultrasonography of nodular and infiltrative lesions of the skin and subcutaneous tissues. J Clin Ultrasound 1990;18(2):103-9.
Lee HJ, Im JG, Goo JM, Kim KW, Choi Bl, Chang KH, et al. Peripheral T-cell lymphoma: spectrum of imaging findings with clinical and pathologic features. Radiographics 2003;23(1):7-26.
Juan YH, Saboo SS, Tirumani SH, Khandelwal A, Shinagare AB, Ramaiya N, et al. Malignant skin and subcutaneous neoplasms in adults: multimodality imaging with CT, MRI, and 18F-FDG PET/CT. AJR Am J Roentgenol 2014;202(5):W422-38.
Levine BD, Seeger LL, James AW, Motamedi K.. Subcutaneous panniculitis-like T-cell lymphoma: MRI features and literature review. Skeletal Radiol 2014;43(9):1307-11.
Kim EY, Kim SS, Ryoo JW, Na DG, Roh HG, Byun HS, et al. Primary peripheral T-cell lymphoma of the face other than mycosis fungoides. Computed tomography and magnetic resonance findings. J Comput Assist Tomogr 2004;28(5):670-5.
Floque SR, Child FJ, Whittaker SJ, Ferreira S, Orchard G, Jenner K, et al. Subcutaneous panniculitis-like T-cell lymphoma : a clinicopathological, immunophenotypic and molecular analysis of six patients. Br J Dermatol 2003;148(3):516-25.
Fujii K. New Therapies and Immunological Findings in Cutaneous T-Cell Lymphoma. Front Oncol 2018;8:198.
